The Last Thing My Mother Wanted

In September 2022, the author's 74-year-old mother, healthy apart from a deteriorating cataract, foot pain and a pacemaker, flew to Basel to die through Pegasos, a Swiss voluntary-assisted-death organization. She had no terminal diagnosis. Her route ran through Pegasos's "tired of life" category, which lets in elderly people without a terminal illness whose quality of life has become poor in their own estimation. Her reasons were that the world was going to hell, that everyday pleasures had gone flat, and that she dreaded the indignities of aging and becoming a burden. The trigger was her longtime partner's death from glioblastoma in California in 2020 under that state's death-with-dignity law, after which she left San Francisco for New York and, by the author's account, lost nearly all interest in life. The cost of the service was over $10,000, and the anesthesiologist explained the lethal dose of 15 grams of Nembutal in blunt terms, saying it was enough to sedate three and a half elephants. The author and her sister only learned of the application by accident, during a phone call in June 2022. Their reactions split between believing she would follow through, given her lifelong libertarian streak and her long-standing living will, and doubting her, given a history of abandoned projects, half-finished degrees, and threats she never carried out, such as the will she amended and then reverted. The piece is less a debate over assisted death in the abstract than a daughter's attempt to get some reckoning from a mother who was, by her account, never much of a parent. Long before the Pegasos plan, the author describes an affair with a friend's mother that she found out about as a kindergartner, a later affair with a Columbia anthropology professor when she was about eight, and a general pattern of secrecy and emotional distance. The writer has a loose tie to the wider policy debate. She notes that ten U.S. states allow physician-assisted death only for terminally ill residents with six months or less to live, that Canada requires an incurable condition with intolerable suffering, and that Switzerland's rules are far looser, which makes it a destination for people without a terminal diagnosis. What the piece leaves to the reader is the tension between the mother's stated autonomy and the family's uncertainty about whether that autonomy was being exercised clearly, especially since she had refused therapy her whole life and no record of mental illness was ever documented.